Family physician, author, blogger, speaker, physician leader.

ICYMI – In Case You Missed It – October 2015 – for Physicians and Physician Leaders

I think, at a child’s birth, if a mother could ask a fairy godmother to endow it with the most useful gift, that gift would be curiosity. – Eleanor Roosevelt

Health Care

  • The next great challenge for doctors – Judgement calls. Clinching the RIGHT diagnosis. CriticalScreen Shot 2015-10-07 at 7.30.20 PM if we are to make care more affordable. The Institute of Medicine (IOM), which released the 2000 report To Err is Human: Building a Safer Healthcare System, is out with Improving Diagnosis in Health Care. “…the occurrence of diagnostic errors — has been largely unappreciated in efforts to improve the quality and safety of health care. Doctors can get better only if we get feedback – “as of now we don’t have well-developed mechanisms for doctors to get feedback on the accuracy of their diagnoses, and information about the ones they get wrong.”  To improve your diagnostic skills – listen mindfully to your patient! 
  • Challenging the status quo is why UCSF Breast Cancer Surgeon Laura Esserman, Stanford ’83 MD, ’93 MBA inspires me. Profiled recently in the NY Times, she does not believe that ductal carcinoma in situ is cancer…one of the most vocal proponents of the idea that breast cancer screening brings with it overdiagnosis and overtreatment. Her philosophy is controversial, to say the least. For decades, the specter of women dying for lack of intervention has made aggressive treatment a given….but last month, her approach was given a boost by a long-term study published in the journal JAMA Oncology. The analysis of 20 years of patient data made the case for a less aggressive approach to treating a condition known as ductal carcinoma in situ, or D.C.I.S., for which the current practice is nearly always surgery, and often radiation. The results suggest that the form of treatment may make no difference in outcomes. She pioneered same day multidisciplinary breast clinic at UCSF over a decade ago.  In the summer of 2010, she united all of the five UC breast cancer clinics across the state to share and determine outcomes data. She notes that teamwork — “something I didn’t learn how to do until business school” and is the future of medicine and medical research.
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Outside Health Care


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What did I miss? What else would you add? 









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